Journal of diabetes investigation 2017 04 11() doi 10.1111/jdi.12676
The incidence of type 2 diabetes is higher in elderly patients, in whom this disease is associated with dementia, falling, stroke, and death. We utilized a continuous glucose monitoring (CGM) device to analyze the relationship between hypoglycemia and diabetes treatments to identify risk factors for hypoglycemia (defined as a blood glucose level <70 mg/dL). MATERIALS AND METHODS
We classified 170 patients aged ≥65 years with type 2 diabetes who were receiving steady-state medication (29 of whom were inpatients) into hypoglycemic and non-hypoglycemic groups, and compared their HbA1c levels, treatment types, continuous glucose monitoring data, and other parameters. We performed univariate analyses to identify variables associated with hypoglycemia risk, followed by multivariate analyses of drug class and other factors. The accuracy of the CGM data was confirmed by calibration.
Hypoglycemia risk was higher in the patients using insulin (odds ratio [OR]: 2.17, 95% confidence interval [CI]: 1.16-4.08, P=0.015), and lower in patients who were being treated with dipeptidyl peptidase-4 inhibitors (OR: 0.47, 95% CI: 0.25-0.89, P=0.019). Patients with lower variability in blood glucose had a significantly lower hypoglycemia risk (OR: 0.87, 95% CI 0.83-0.91, P<0.0001), and those with a lower average blood glucose level had a significantly higher risk (OR: 1.09, 95% CI: 1.06-1.12, P<0.0001). CONCLUSIONS
In patients aged ≥65 years with type 2 diabetes, higher glucose variability and lower average glucose levels indicate a greater hypoglycemia risk. It is therefore necessary to ensure comprehensive blood glucose control in such patients to prevent hypoglycemia. This article is protected by copyright. All rights reserved.